Health donors, policymakers, and practitioners continuously make life-and-death decisions about which type of patients receive what interventions, when, and at what cost. These decisions—as consequential as they are—often result from ad hoc, nontransparent processes driven more by inertia and interest groups than by science, ethics, and the public interest. The result is perverse priorities, wasted money, and needless death and illness. Examples abound: In India, only 44 percent of children 1 to 2 years old are fully vaccinated, yet open-heart surgery is subsidized in national public hospitals.
CAPE TOWN — Travel clinics have inadvertently sparked a nationwide shortage of yellow fever vaccines by advising travellers to Zambia to get the shots, even though the country is not on the Department of Health’s list of destinations from which travellers must provide yellow fever certificates before entry into SA.